Certification Of Disc Destruction For Secured Data Hdd Accounts Form printable pdf download

Certification Of Disc Destruction For Secured Data Hdd Accounts Form

CERTIFICATION OF DISK DESTRUCTION FOR SECURED

DATA HDD ACCOUNTS

Certification statement:

By signature below I certify that due to sensitive data on hard disk drives (hdd)

in use by this agency. Hdd’s may not be removed from this site. Therefore, this

certificate of destruction is in agreement between the agency/company and

………………………………………..

When a disk drive requires replacement under warranty or service

agreement, this certificate of destruction having all of the information

inserted and signed by the designated personnel will serve, as evidence of the

complete destruction of the hdd and a replacement under warranty will be

authorized.

Drive part number………………………………………………………………………………………….

Supplier drive part number………………………………………………………………………………

Model

number……………………………………………………………………………………………………………

Manufacturing build date

Description of reason for failed drive

***************attempt to remove the top cover drive label and attach to this

form, or send TOP PLATE OF DRIVE *****************

Please note that this form will not be accepted without a valid serial number

indicated above

Signed……………………………………………………………………………………………………………………..

Agency/company……………………………………………………………………………………………………

Certification Of Disc Destruction For Secured Data Hdd Accounts Form